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Nerve-block anesthesia can improve surgical recovery, even outcomes
August 05, 2009
NewYork-Presbyterian Hospital offers nerve-block anesthesia, with advantages including improved pain relief NEW YORK - When planning for surgery, patients too often don't consider the kind of anesthesia they will receive. In fact, the choice of anesthesia can improve recovery, even outcomes.
Regional nerve blocks, an anesthesia technique available at NewYork-Presbyterian Hospital, are known to improve pain relief, reduce side effects and allow patients to go home sooner when compared with general anesthesia. With the introduction of ultrasound guidance, nerve blocks have become more accurate, making the technique available in the treatment of an increasing variety of conditions, including breast cancer surgery.
Dr. Anthony Robin Brown is director of the Division of Regional Anesthesia at NewYork-Presbyterian Hospital/Columbia University Medical Center.
"Nerve blocks target a specific area of the body, such as an arm or chest. With this approach, patients can avoid the downsides of general anesthesia during surgery and opioid-based medications used to control pain during recovery. The upshot is fewer instances of nausea, confusion, sedation (sleepiness) and pain, and a quicker recovery," says Dr. Brown, who is clinical professor of anesthesiology at Columbia University College of Physicians and Surgeons. "If patients prefer, they can remain awake during surgery and watch the procedure as it happens on video monitors. They also have the option of sedation that puts them to sleep."
Another potentially major advantage: Preliminary published research indicates that nerve blocks could help prevent the recurrence of cancer[1]. The theory is that the stress of surgery can weaken the immune system, making recurrence more likely. General anesthesia and opioid-based medications only mask surgical stress. In contrast, nerve blocks work directly on the area of the body where the surgery is taking place. This prevents the initiation of the surgical stress response, with the result that the immune system function is not compromised.
Dr. Tiffany Tedore is director of the Division of Regional Anesthesia at NewYork-Presbyterian Hospital/Weill Cornell Medical Center. She is leading a clinical research study comparing nerve blocks with general anesthesia for breast cancer surgery to see which approach results in better pain control, fewer side effects and quicker recovery.
"Traditionally, breast cancer surgery has involved two kinds of anesthesia -- local anesthetic and sedation for biopsy, followed by general anesthesia for larger procedures such as mastectomy. Our study is looking at the benefits of replacing general anesthesia with a nerve block," says Dr. Tedore, who is also assistant professor of anesthesiology at Weill Cornell Medical College. "I anticipate our future studies will also look at cancer control."
New York- Presbyterian Hospital/Columbia University Medical Center
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Anesthesia Secrets: with STUDENT CONSULT Access
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The Secrets Series® is breaking new ground again. A two-color page layout, a portable size, and a list of the "Top 100 Secrets" in anesthesia help you to better meet the challenges they face today. And, at no extra charge, you’ll also receive online access to the complete contents of the text via Elsevier’s innovative STUDENT CONSULT website. You’ll still find all of the features you rely on the Secret Series® for—a question-and-answer format, lists, mnemonics, and tables and an informal tone that make reference fast and easy. No matter what questions arise in practice or while preparing for boards, this new volume has the answers you need—in print and online. The smart way to study! Elsevier titles with STUDENT CONSULT will help you master difficult concepts and study more...
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Today's leading authorities present the succinct, yet thorough guidance you need to successfully avoid or manage complications stemming from pre-existing medical conditions. Organized by disease, the new edition of this popular guide has been completely revised and updated to reflect the latest information on definition, current pathophysiology, significant pre-, intra-, and postoperative factors of the disease process, anesthetic judgment, and management. A new, more user-friendly design and organization-and completely redrawn illustrations-make reference easier than ever. And now, as an Expert Consult title, this reference includes access to the complete contents online, for convenient reference where and when you need it!
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